Employee Resignation/Termination Form
Directions:
Complete Form in its Entirety
Review with Employee. Have them sign & date.
Upload any related files (texts, emails, docs, screenshots, etc.)
Complete dismissal/termination form by clicking "Submit"
Store/Location
*
Please Select
Chevrolet
Dodge
GC
Employee #:
Employee Name:
*
First Name
Last Name
Job Title:
*
Department
*
Please Select
Sales
Finance
Service
Parts
Accounting
Other
Date of Hire (if known):
-
Month
-
Day
Year
Date
Last Day Worked:
*
-
Month
-
Day
Year
Date
Supervisor:
*
Supervisor Email
example@example.com
Dismissal/Termination Date:
*
-
Month
-
Day
Year
Date
Employee Dismissal:
*
Resignation (attach letter)
Dismissal
Retirement
Mutual Agreement
Layoff
Other (attach explanation)
Reason For Dismissal:
*
Absenteeism/Tardiness
Job Change
Personal
Reduction In Force
Performance (attach explanation)
Violation of Policies/Proceedures
Other (attach explanation)
Explanation for Dismissal/Comments:
*
Back
Next
Any related docs about dismissal (texts, emails, docs, screenshots, etc.):
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Employee's statement (attach written statements using upload feature above):
Manager's comments or special instructions:
Can the employe be rehired?
*
Yes
No
Under the following circumstances:
The reason why he/she cannot be hired again:
Today's Date:
*
-
Month
-
Day
Year
Date
Employee Signature:
Supervisor Signature:
*
Submit
If you still need a physical copy you can download one here:
Should be Empty: